Month: April 2011

Two days after surgery I had a visit from the specialist urologist and his friend the oncologist.

They have news. It’s exciting, I can tell. It’s written all over their faces. The cancer is the biggest one they’ve ever removed, or at least the biggest kidney cancer. It was 17cm across, and weighed 7kg. That’s bigger than a large supermarket chicken, and the weight of two moderate babies.

Typical men: it’s all about size.

But then they explain that the exciting news is that it was all contained within the kidney – none of it had spread to other organs, which is actual, real life good news. They took out an adrenal gland as well, just to be sure, but it looks like surgery has solved the problem.

I no longer have cancer. Now we just have to wait for the histology reports, so we know what type it was, and what chance there is of it returning.

I have to move

I can’t lie around. If I do, my stomach muscles will start to heal in an odd position, and I’ll be permanently warped. Physically, they mean. I’m already mentally and sexually warped.

So 4 nurses carefully ease me into a sitting position, and then I’m gently hauled to my feet. I’m made to stand as straight as I can and told to walk 20 paces. This is easier said than done, and I have to stop for a rest a couple of times. I’ve done 20 paces and I’m exhausted, and need my next morphine dose. But look: I’m 20 paces away from it, and now I have to work out how to turn around and go back.

No more fun

Morphine gives you incredible dreams. Hearing about other people’s dreams is profoundly dull, like being the only blind person at a 2 hour slide show presentation of somebody else’s holiday snaps. So I’ll spare you the details, and simply tell you that at once stage I was flying over 1945 Berlin, dropping sherbet bonbons, which exploded into clouds of sugar. Bonbons featured in a lot of my dreams, and I haven’t had one, seen one or thought about one for 30 years or more.

But the fun is over. I have to come off the morphine now. It’s only 2 days since the operation, but from now on I’m their bitch. Regular walks, marching up and down the ward. And all that waits for me is a cup of tea and a few mild little cocodamol tablets.

And then

And then I’m sent home. Four days later, and just in time for Doctor Who.

The human body is remarkable. They made a 13 inch cut across my belly, hacked their way through me until they reached the back and cut out a vital organ. Two days ago I could hardly walk. Today I got out of bed on my own, showered, dressed, and did 20 laps of the ward. So I don’t need them any more, and I’m going.

Brother came to collect me (girlfriend doesn’t drive). I carried my own bag down to the hospital reception because I couldn’t wait to see the back of that fucking ward. Don’t get me wrong, the staff are amazing and the service is incredible. It’s only a few weeks since I discovered I had a massive cancer, and only 4 days since surgery, and now I’m cured and on my way to my own bed. But by God and Sonny Jesus, I never want to be here again.

I’ve lost 3 stone in weight, although almost 2 stone of that was left on the surgical bed. But I’m fine, and glad to feel the wind on my face as we walk slowly to the car.

That’s all I remember until I start to come round in the lift heading back up to the ward.

It’s seven hours later. Pain pain pain pain pain pain… and then I realise I’m saying it out loud and make myself stop. Three people stand over me in the lift. I ask them if it went OK, and they bend over me to try to understand what I’m saying, but maybe they can’t, or maybe I can’t remember their reply.

Next thing there are hands all around my face, and I figure out I’m in the corridor outside the ward, and the hands belong to my family. I can’t see mum but I can hear her saying my name over and over. Brother later told me he was angry with her – she’d insisted on staying away until 2 minutes before I went into surgery, when she’d suddenly insisted on being present. He’d wanted to wait for me the whole time, but had to leave to fetch her. Doesn’t matter, I was under for 7 hours, he could have driven to Edinburgh and back.

They all look so worried, so I say, “I’m OK. I’m OK”. And then I realise I have no idea if I am or not, and ask, “Am I OK?”. I don’t think they understand any of this.

Apparently my first cogent words were “The epidural failed”, which banjaxed the whole family. None of them even knew I was pregnant.

Memory of the next bit comes and goes, but I remember being told how to use the morphine drip. Here’s the button. If it hurts, press it and you’ll be given a dose.

I press it and nod out. When I come back they’re explaining again and asking me to not press it until they’ve finished explaining: I can press it once every 3 minutes. I press it because it hurts, and nothing happens. I have to wait until the light comes on. This is the longest 3 minutes since Ali vs Frazier.

Counting to 180 is too difficult in my current state of mind, so I just press it and press it until I nod out.

I’m awake more fully in the night, or perhaps early morning. The anesthetic fug has worn off, and I can tell what’s happening a little more, but only when the morphine is overwhelmed by the pain and I’m dragged into an urgent awareness of what I need to do: press the button. I can’t move very much. Even lifting my head off the pillow is very painful in my belly, and I struggle to look down at my wound. A pipe leads out of my lower abdomen, and I don’t know why. Nobody had mentioned this before.

A nurse comes in and I hand her my phone and ask her to take a photo, partly for a record and partly so I can see what’s been done. I had asked if someone could take a photo of the surgery, but it’s not allowed. This is the next best thing.

When I see the photo I’m appalled. Am I that fat? But no, it’s swelling. It’ll go down.

The wound is as big as I’d expected. It’s 1/3 of the way around my body. It’s cut through the major muscle groups in my stomach, which means I can’t lift my legs or head, turn my body, or bend in any way. When I get a dose of morphine and nod out, I almost always drop button and it falls on the floor. When I come round I panic and yell for someone to hand it to me. After a few times they tie it to my wrist.

I have visitors. Everyone. I think I’m doing OK and chatting with them, but afterward they tell me that I was caned off my tits, and just stared at the morphine button waiting for the light to come on. When it did I’d press it, nod out for 2 minutes, and then the pain would wake me up in time to press it again. If they were lucky, they could get me to say a couple of words in that few brief moments between consciousness and the next dose of morphine.

It turns out the pipe coming out of me is a precaution. Kidney surgery either doesn’t bleed at all, or bleeds in pints. The pipe lets them syphon off blood.

My surgery was planned for 17th, but after the TWOC fiasco they decided to bring it forward.

So surgery actually happened on the 6th. The night before I wrote some notes on my broken phone, just in case things came out badly. Just a few little messages for my mum and girlfriend, and a final invitation for my brother to fuck off.

I’ve deleted them now. They were very sentimental, which isn’t like me at all.

The show started at 1pm, so in the morning I watched everyone else eat Weetabix, and then had a nap on the bed. If I was worried, it wasn’t preventing me from sleeping.

Am I a sociopath?

Brother arrived at 12:00 and told me he’d wave me off for the operation, and welcome me back afterwards. He must be concerned, he’s never been nice to me before. Mum isn’t coming because “she doesn’t want to get in the way”. We laugh about this. Typical: she worries about everything, and now she thinks that her presence in the hospital will somehow put off the surgeons? She’s an absolute nervous mess.

I read for a bit, and then the porters came in and wheeled me down. En route I was overtaken by my surgeon. He’s so confidently blasé about it all, the polar opposite of my hilariously terrible GP. An operation this big probably happens to 1 in 10,000 people, and is an incredibly big deal for me. But for him it’s every day. Probably twice a day. It’s a job.

Prep was unexpected, but then I don’t know if I’ve ever thought about it before. It’s a small ward of perhaps 20 beds, with a constant turn-over. I was there for maybe 35 minutes, and in that time the entire population of the ward changed twice. It’s a production line. We’re not patients down here, we’re a bunch of malfunctioning machines.

I’m asked the same questions 5 times, once every 5 minutes. I guess they have to be very certain they’re doing the right thing to the right person:

What’s your name?

What’s your date of birth?

What’s wrong with you?

What surgery are you having today?

I like saying “right radical nephrectomy” rather than “right kidney removed”. It gives me that same sense of belonging that you get when you manage to use a few words of French in Paris.

The anesthesiologist told me they’re going to give me an epidural so I can cope with the pain after the surgery. Odd: I hadn’t even thought about pain after surgery. I’m glad he has! So I’m wheeled in to pre-op and made to sit on the side of the bed. An assistant sticks a huge plastic sheet to my back and makes a small hole in it. I’m asked to arch my back as much as I can, so my chin is pressed on my chest.

I try, but I’m a rugby boy. Thick set, sturdy, inflexible. I can’t bend enough to make a gap between the vertebrae, and he keeps trying and trying. He’s put the needle in 4 times, and still can’t get into the epidural canal. I can feel him getting frustrated behind me.

The assistant holds me by the neck and pushes my head down as far as he can, but this just isn’t happening. So they give up and tell me they’ll work out a different pain regime for me while I’m under. They tear off the plastic sheet, and I feel like I’m being waxed.

I lie down. A drip or two go in, and a bunch of cardio sensors on my ankles, chest and neck. I’m perfectly calm, I notice. Am I a sociopath?

The anesthesiologist gives me a cord to hold with a button at the end. He tells me not to press it, and suddenly I’m reminded of Dougal in Father Ted, being invited into the cockpit and seeing a big red button marked “Do Not Press”. They’re bustling around above me.

It itches and scratches inside me. It prevents me from lying in any position except flat on my back, when everyone who’s ever tried to sleep with me has found out I prefer to lie face down like a little baby.

And if I do manage to nod off in an uncomfortable position with a pipe scratching the inside of my penis, I’m woken up every 2 hours to have the saline bag changed.

So I’d been looking forward to TWOC day. TWOC is Trial Without Catheter, which basically means they take it out and see if I can pee. Over the last few days the saline has been coming out increasingly pale pink, like a Rosé in a nightmarish restaurant, and now it’s totally clear. It looks like I’m no longer bleeding, and can go home until my surgery.

So they whip out the catheter (deep breath, hold it, then breathe out fast as they pull 30cm of tube out of me). Then a nurse watches me drink 2 litres of water, which I have to pee out into a jug so they can be sure it’s all working, and no more blood clots are present in my bladder.

2 hours later and it’s all going terribly wrong. A tiny dribble and a couple of hard, nasty clots thudding into the jug. Pain is coming back, like it did the day I was admitted. Oooof. This is bad. Oooof. Oh my God. Oh my serious God.

A nurse tries to put the catheter back in to relieve the pressure, but it’s absolute agony. The tube won’t go in, and it’s about 8mm across, and she’s trying to push it a hole that has closed tight. She can’t get my urethra to open up. She shoves harder and harder, but it’s just like being slowly stabbed with a blunt knife in the most sensitive part of my most sensitive parts. It’s clearly not working, and the pain is getting worse, and I’m making noises that are scaring other patients.

After 2 more brief attempts she gives up and calls for a doctor. In he rushes, with a sweat on, and in full surgical gowns – he was just about to start an operation when he was called to me. He’s Polish and unfeasible blonde and handsome. He looks like an extra from something American; I can’t remember what but it’s a programme I hate, and now they’re giving me a huge dose of morphine and examining my cock. I’m naked and hurting and making intermittent squeaking noises that I’m trying to suppress; and there are 5 nurses and a doctor bending over looking at my penis, which has shrivelled to walnut in response to the mixture of pain, fear and cold.

Here comes the morphine. It’s not a high, it’s something else. It’s very nice. It’s a sense of being outside, just watching. Yes, there’s pain, but somehow that’s fine. The Polish doctor pinches my cheek, looks at my eyes, and starts again with the catheter.

Oof. Even the morphine isn’t doing anything for that. He can’t make it go in. The morphine makes his voice seem a long way away, but I hear him say “get a theatre ready”, and I say “I can’t go to the theatre dressed like this”, and he smiles like he’s never heard it before, which perhaps he hasn’t. Did I just make it up? Why won’t my brain work properly?

But the pain is coming back, and he scans my bladder and says he may have to do it here. I later found out that my bladder was in danger of rupturing because of the amount of liquid in it, and he was considering just slicing it open without anaesthetic, right there on the bed, because it’s a safer option.

But then someone brings gas and air, and my morphine haze gets really weird. My ears are buzzing, and someone squeezes the glans at the head of my penis to force the urethra open. Someone says “hold him” and 4 male nurses put their hands on my shoulders and thighs, and everything goes bright and sharp for about 2 seconds. And then it’s over. The catheter is in, and I’ve already filled one bag.

They’re putting another on, which I fill immediately. I’m filled with gratitude, and tell the Polish doctor that I hate him for what he just did, which I assume he’ll realise is a joke, but he looks genuinely offended. I try to apologise and explain, but the morphine is making me nod out, and my mum, brother and girlfriend have arrived to visit.

I found out later that they were stood just outside of my curtained-off bed, listening to me screaming. I didn’t know I was. My mum was in tears, and my girlfriend still won’t talk about it.

It turns out that catheters aren’t supposed to feel as itchy and scratchy as mine did. I had an allergic reaction to the latex tube, and the inside of my urethra had blistered and swollen. When they took out the catheter the hole clamped tight shut, so nothing could come out, and nothing could go in.

I had pain all through the night: bladder cramps brought on by the stress it was put under earlier in the day. A hugely sympathetic and wonderful Filipino nurse sits with me in the small hours, and holds my hand while I have a little cry. I tell her I’m ashamed of myself, and she tells me I shouldn’t be. Medical staff give marks out of 10 for pain. Childbirth is an 7, but bladder cramps are a 9. I ask what a 10 is, but she won’t tell me. I have a ghastly imagination, and all I can think of is the bloody stumps and the London bombings.

I now have an answer for any woman who uses the lazy “agony of childbirth” argument.

They’re not going to try another TWOC. I’m here until the operation. And Doctor Who starts on Saturday. I’ll miss it. Damn.